Navigating disability support services can feel overwhelming, especially when trying to determine if you or a loved one qualifies for the National Disability Insurance Scheme (NDIS). Understanding who is eligible for NDIS is crucial for accessing the supports and services you need to live your best life and develop lifetime skills that enhance independence.
In this comprehensive guide, I’ll take you through all the essential information you need to confidently access this life-changing program.
Who is eligible for NDIS?
The NDIS offers support to Australians living with disability, but not everyone with a disability automatically qualifies. NDIS eligibility is determined by specific criteria that assess your age, residency status, and disability conditions.
Let’s break down who is eligible for NDIS in detail.
The Core Criteria for NDIS Eligibility
Age Requirements
To meet the NDIS eligibility age requirements, you must be under 65 years of age when you apply.
It’s important to note that once you’re an NDIS participant, you can continue receiving support even after turning 65, provided you become a participant before your 65th birthday.
Residency Status
To satisfy the NDIS eligibility residency requirements, you must:
- Be an Australian citizen, OR
- Hold a permanent visa, OR
- Hold a Protected Special Category Visa
- Live in Australia where the NDIS is available
Disability Requirements
Meeting the disability requirements is perhaps the most complex aspect of NDIS eligibility. This can be met in one of two ways:
1. Permanent Disability Criteria
To qualify under the disability requirements, your disability must be:
- Permanent – This means your condition is likely to be lifelong. You may need to provide evidence showing that all reasonable and available treatment options have been considered.
- Significant impact – Your disability must substantially reduce your ability to participate effectively in daily activities, social interactions, or economic participation.
To be eligible for NDIS, your disability must result in substantially reduced functional capacity in at least one of the following domains, meaning you can’t effectively perform activities in that area without assistance from other people, equipment, or accommodations.
| Functional Domain | Examples of Substantially Reduced Capacity |
| Mobility | Unable to walk independently, requires mobility aids, significant physical limitations |
| Communication | Difficulty expressing needs, understanding others, requires communication devices or interpreters |
| Social Interaction | Challenges building relationships, understanding social cues, maintaining appropriate behaviour |
| Learning | Difficulties with concentration, memory, and problem-solving, needs significant educational adjustments |
| Self-care | Requires assistance with personal hygiene, dressing, eating, medication management |
| Self-management | Struggles with planning, organisation, decision-making, money management |
2. Early Intervention Requirements
Alternatively, you may qualify for NDIS under early intervention requirements if:
- You have a permanent disability or are a child under 6 with developmental delay, AND
- There is evidence that getting supports now will help reduce your future needs for support, AND
- The early intervention supports are most appropriately funded through the NDIS
Who is NOT Eligible for NDIS
Understanding who is not eligible for NDIS is just as important as knowing who qualifies. You may not be eligible if:
- You’re 65 years or older at the time of application.
- You’re not an Australian citizen or permanent resident.
- Your disability is not permanent or likely to be permanent.
- Your disability doesn’t substantially impact your functional capacity.
- Your support needs are more appropriately met through other systems (like health or education)
It’s important to note that the NDIS does not replace other systems. If your needs are primarily related to healthcare, education, housing, or employment, these should be addressed through those specific systems first.
If you believe you meet the NDIS eligibility criteria, here’s how to apply:
The NDIS Application Process
1. Gather Your Documentation: Prepare the necessary documentation, including medical reports from healthcare professionals, proof of residency, and identification documents.
2. Initiate Your Application: Get in touch with your local NDIS office or your local disability services organisation and complete the application using the online portal.
3. Submit Your Application: After filling out the application form, submit your application either online or through the specified postal process.
4. Undergo an Assessment: Once your application is submitted, a trained assessor will review your application and supporting documents. This may include interviews.
5. Develop Your Support Plan: If your application is successful, work with a planner to develop a personalised plan outlining the supports and services that will be provided.
Note: The NDIS aims to respond within 21 days if they have all the required information. If not approved, you’ll receive an explanation and information about the review process.
Common Reasons for NDIS Application Rejection
Not everyone who applies for the NDIS will be approved. Common reasons for rejection include:
- Insufficient evidence of the permanence of the disability
- Inadequate documentation of functional impact
- Conditions considered primarily health-related rather than disabilities
- Age or residency requirements not met
- Incomplete application forms
If your application is rejected, you have the right to request a review of the decision within three months.
Still Unsure About Your NDIS Eligibility?
If you’re still unsure about your NDIS eligibility, you don’t have to figure it out on your own. TK Community Care is here to help.
Whether you need help understanding eligibility, gathering documentation, or submitting your application, our compassionate team is ready to assist.
Contact TK Community Care today and let’s find out together if you or someone you care for is eligible for NDIS.
